A Roadmap to Pre-Implementation of Electronic Health Record: the Key Step to Success

Abstract

Introduction:Initial attempts are made to implement electronic health record (EHR) in Iran, the present study aim is developing a proper roadmap to EHR in pre-implementation phase by expert views on the matter.Method:An initial framework was developed for preimplementation based on reviewing literature on EHR implementation and descriptive-comparative with qualitative approaches in five countries. A questionnaire was designed in several sections using 47 main topics associated with pre-implementation. Cronbach’s alpha 0.89 confirmed the reliability of the data. Expert views were used to score each topic based on Likert scale and opinions were collected through Delphi. Then results analyzed using descriptive statistical analysis method.Result:Framework of EHR pre-implementation roadmap was presented in four phases: preliminaries, assessment, planning, and method of choosing system vendors. Priorities in each part were determined and reflected in the roadmap using expert views, analyses, and requirements of each phase. It seems strategic planning at different levels; assessment of needs; providing and managing financial resources, setting standards; examining the existing condition was determined as highest priorities in above phases.Conclusion:For successful implementation, developing national carefully-designed and well-documented EHR pre-implementing roadmap, Based on country situation, from strategic to operation level is necessary.

Implementing a Large-scale Electronic Health Record System in the Primary Healthcare Centres in Saudi Arabia

“…The selection of the project team is a vital contributing factor towards successful EHRS implementation (Adler, 2007;Carayon et al, 2009;Lorenzi et al, 2009). While some research has suggested that the formulation of an EHRS implementation project team should be the first step in the process of implementation (Adler, 2005;Sanchez et al, 2005), others have argued that the decision regarding composition of the project team is a step which should be taken only once the EHRS implementation plan has been approved (Ghazisaeidi et al, 2014). The project team are responsible for formulating a project plan, therefore the project team should be established early to ensure that all team members are involved in the early stage processes such as planning and decision-making.…”

“…The project champion role is important to the successful implementation of an EHRS (Ludwick & Doucette, 2009b;Terry et al, 2008) and should be appointed in the early stages of implementation (Ghazisaeidi et al, 2014;Ross et al, 2016), especially the planning phase. The project champion's role is to act as a communication channel between project managers, project team members, and EHRS end-users (Yoon-Flannery et al, 2008), as well as the vendors of the technologies (Adams andCulp, 2005, Miller et al, 2003).…”

“…This requires coordination, cooperation, teamwork, and trust within the group (Lorenzi et al, 2009), as well as good communication with vendors (Keshavjee et al, 2006;Ludwick & Doucette, 2009b). Effective project team communication should be established from the pre-implementation phase (Ghazisaeidi et al, 2014;Lorenzi et al, 2009). Effective communication between the project team and end-users can help to ensure wide end-user acceptance of the EHRS (Keshavjee et al, 2006;Lorenzi et al, 2009), and avoid any implementation issues such as systems interoperability or lack of training (Keshavjee et al, 2006;Ludwick & Doucette, 2009b).…”

“…Previous literature has recommended defining specific time scales to involve EHRS endusers. While some researchers suggested involving EHRS end-users in the evaluation and readiness assessment (Cucciniello et al, 2015;Hartzler et al, 2013), others have suggested including them in the pre-implementation (e.g., planning) phase of the project (Ghazisaeidi et al, 2014). However, EHRS end-user involvement must be continuous and not confined to certain stages.…”

“…It is important to start planning the implementation of the EHRS in the early stages (Fullerton et al, 2006;Ghazisaeidi et al, 2014;Poon et al, 2004). The literature has emphasised the essential role of planning in the success of EHRS implementation Yusof et al, 2008).…”